Provider Demographics
NPI:1528016482
Name:JAYHAWK PRIMARY CARE INC
Entity Type:Organization
Organization Name:JAYHAWK PRIMARY CARE INC
Other - Org Name:PICTURE HILLS AFTER HOURS URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MYRTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-588-9808
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:MEDICAL ADNINISTRATIVE SERVICES OF KU MED. STE. 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9000
Mailing Address - Fax:913-588-9822
Practice Address - Street 1:6515 N COSBY AVE
Practice Address - Street 2:PICTURE HILLS AFTER HOURS URGENT CARE
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-2380
Practice Address - Country:US
Practice Address - Phone:816-505-5050
Practice Address - Fax:816-587-7708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
22039026OtherBCBS GROUP NUMBER
=========OtherJAYHAWK TAX ID
MOJ610000Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER